panic attack or panic disorder (sudden anxiety that occurs without warning) with or without agoraphobia (fear of open spaces; not being able to leave your home)

specific phobias (many types of intense fear reactions of specific objects or situations, such as fear of spiders, flying, or heights)

social anxiety or social phobia (fear of being embarrassed in social situations)

generalized anxiety disorder (general feeling of anxiety most of the time)

obsessive-compulsive disorder (unwanted thoughts or behaviors that are repetitive and unnecessary)

post-traumatic stress disorder (anxiety associated with and that occurs after a stressful life event)”

If you have any of these concerns, help is available. Each interferes, some more and some less, in daily life and achieving your goals.

You can contact me through my website and I can help you find an appropriate referral for your area. Psychiatrists and therapists can treat anxiety disorders, and generally speaking are very nice people. If you find a psychiatrist or therapist you don’t like, keep looking. You have the right to be treated by someone you feel comfortable with.

When an individual is “triggered” and anxiety results, how can they cope? If their nervous system is set to high most of the time, it doesn’t take much of a trigger to set up a panic attack or high levels of anxiety that can interfere with functioning. It’s kind of like a cup that is almost full having to accept a small amount more of liquid, and then overflowing, even though the added amount was relatively small. If the cup weren’t already overflowing, the small amount added wouldn’t have caused the liquid to overflow.

One solution for some is to lower the level of liquid in the cup to begin with. That way, when an average amount of liquid is added (like some kind of stress from the day), the cup doesn’t overflow.

So how do you lower the level of liquid? While it may sound like a cliche’ and therefore may be dismissed easily, if one can manage the fullness of the cup, one may be able to stay ahead of overwhelming anxiety. Managing the fullness of the cup is basically stress management, keeping the level in the cup low. Breathe. Practice “here-and-now” orientation (aka “mindfulness”). Avoid catastrophizing (the “what ifs”). Self-soothe with healthy behaviors (exercise, meditation, relaxation exercises, using your support system, etc.). Breathe. Taking oneself to a safe or peaceful place in one’s mind. Doing something fun. Getting a massage (or pedicure, manicure, facial, or whatever feels soothing). All of these behaviors can keep the level of stress in one’s life lower, keeping down levels of anxiety as well.

Not all of these ideas work for everyone. But something can work for you. Explore. Experiment. Pay attention to how your body feels when you are doing something, anything, and make note. If you’re eating while driving and talking on the phone (bad idea right?), notice how your body feels. Hang up the phone and pay attention. Pull over and put down the hamburger and fries. Are your muscles tight or relaxed? Is your stomach churning, or calm? Your body will tell you the truth if you will pay attention.

Pet your dog, and notice how your body feels. Or pet the cat. Feed the fish. Watch your child playing. Just notice what the experience is like for your body. Notice what it’s like when your body feels calm. When it feels hungry. When it feels satisfied.

Anxiety can be that feeling that something has to happen now. Now. It is “life or death” (even if it truly isn’t). There’s an urgency, a pressure, an unavoidable rush forward into something, anything, to get relief from the pressure. The brain is hijacked and thinking is difficult. Patience is next to impossible. Blood flows to the extremities for either fight or flight, and the brain just doesn’t get enough blood flow to come up with something besides the inevitable running away, duking it out, or succumbing to some (often unhealthy) self-soothing behavior.

Relate to this? Notice what happens the next time you don’t act on that feeling of anxiety, or craving, or whatever urgent What if you did something else? Or just nothing at all? How long would it take for that urgent feeling to pass? Maybe something else is going on – it’s not just anxiety. Sadness? Anger? Frustration? Shame? Just notice. If it had a color, what color would it be? If it had a temperature, what temperature would it be? If it could hold water, how much would it hold? If it had a shape, what shape would it be? If it had a texture, what texture would it be? On a scale of 0 to 1o, with 0 being completely calm or neutral, and 10 being the most intense you could imagine, where would you put that feeling right now?

And then notice if, when, it shifts. It will. Will it get worse? Maybe. Will it turn from black to red? Maybe. Will it move from my stomach to my chest? Maybe. But it will shift. It is not a permanent, static condition.

Anxiety. Who doesn’t know what that feels like? Butterflies in your stomach. Sweaty palms. Worried, furrowed brow. Can’t stop thinking about the “thing,” like a test, job interview, etc. Most of us can relate to this kind of anxiety.

But that’s just one end of the anxiety spectrum. For those who experience anxiety on a daily basis, it’s not something that disappears when the interview or test is over. Sometimes, an individual doesn’t even know what triggered the anxiety event today, or yesterday, or the day before. The chronic, generalized anxiety is “how it is.” No relenting, and it often gets worse or peaks in panic attacks.

Medications are often helpful, but many are habit-forming, like “benzodiazepines,” such as Valium, Xanax, Ativan, etc. There are other medications that might be helpful, and consulting with a skills psychiatrist and/or psycho-pharmacologist is a very important step to tease out the diagnosis and be evaluated for medications.

Identifying the original source of the anxiety can be a very important step in working on the issue. Trauma often underlies anxiety, with setting the central nervous system on “high,” as the system scans for more threats in the environment. If you find yourself only able to sit with your back to the wall, facing the door, etc. or if you startle easily, you may want to consider having an evaluation for unresolved trauma, or disturbing life events. PTSD (post-traumatic stress disorder) is currently classified on the anxiety spectrum in the DSM-IV.

If you suffer from anxiety in a way that impairs your ability to function or reach your goals, seek treatment. Anxiety is treatable!